Initially he was involuntary but they agreed to let him be voluntary. I think it's because they didn't feel like dealing with the court hearing and that there may have been a loophole for him to get out. Plus he had a private lawyer. The thing is he knows he needed treatment but they want to keep him longer than he wants.

He was going to try a 72 hour notice/AMA but they threatened to take him to court if he asked to leave.

He chose to be voluntary and not go through the court process because he realized he needed help and is willing to do outpatient. He just has been in hospital for over a month now and they want to keep him for another month.

I feel for him and think he's worked hard and deserves to be given a chance to do outpatient. He's got a bad history of ending treatment prematurely and relapsing so it's hard for anyone to believe him especially those who read his medical records.

He has found some other facilities though and has been doing much better than he ever had in the past...I'm proud of him and want him to succeed.

So yeah...to answer your question...he's voluntary but the way the system works he seems to be "involuntary"!!!!!!!!!!!!

Typically (in California anyway) a patient who commits themself signs documentation saying they are incapable of handling their own affairs and sign them over to that of the hospital. Essentially, while volutarily, he said he is not fit to make his own decisions regarding his health.

Depending on how extreme the case is, he could be arrested and sent right back to the hospital. The court threat is very real, and what's the kicker is- since he essentially said he's not sane to know what's good for him- the court will typically rule in favor of the hospital, where they will keep him until THEY see fit. Or worse, be arrested and kept in jail since he will essentially be 5150 and put not only himself in danger by escaping, but the general public (even if he isn't violent and 'sane').

In short, your friend is in a tight situation- he'd have it in his best interest to stay put until the doctors and directors there deem him fit to be returned to society. If he wants though, I'm sure he could request a copy of the commitment paperwork he signed to read over the stipulations to know what he is legally allowed to do and not do.

I think you're thinking about this the wrong way. If the doctors think he should stay further...and he is mentally ill, and has a history of self-destructive behaviour (ending treatment, avoiding treatment).... uh, maybe you should tell him that he should trust the doctors, since he is in NO position to make decisions for himself.

It's not like they gain anything by keeping him there, it's in his best interest. It doesn't matter if he can get away and avoid capture or not - the decision to flee is exactly why he should stay on. That's just his illness making him make bad decisions all over again. I don't know why mental illness often causes these kinds of thoughts but I've seen it happen. Schizophrenic patients deciding they do not need treatment anymore and stopping it. Several times. Even though after each relapse they have much worse symptoms and are generaly miserable and a danger to themselves. But time and time again they decide they know better then the doctors.

I think you're thinking about this the wrong way. If the doctors think he should stay further...and he is mentally ill, and has a history of self-destructive behaviour (ending treatment, avoiding treatment).... uh, maybe you should tell him that he should trust the doctors, since he is in NO position to make decisions for himself.

It's not like they gain anything by keeping him there, it's in his best interest. It doesn't matter if he can get away and avoid capture or not - the decision to flee is exactly why he should stay on. That's just his illness making him make bad decisions all over again. I don't know why mental illness often causes these kinds of thoughts but I've seen it happen. Schizophrenic patients deciding they do not need treatment anymore and stopping it. Several times. Even though after each relapse they have much worse symptoms and are generaly miserable and a danger to themselves. But time and time again they decide they know better then the doctors.

I'm no legal beagle either, but I'm pretty sure the hospital DOES gain something by keeping him there if they feel it's at minimum "medically necessary" all in the context of your good post. Namely, it would seem they gain liability protection if he were to leave and then like harm or kill himself or others.

I think you're thinking about this the wrong way. If the doctors think he should stay further...and he is mentally ill, and has a history of self-destructive behaviour (ending treatment, avoiding treatment).... uh, maybe you should tell him that he should trust the doctors, since he is in NO position to make decisions for himself.

It's not like they gain anything by keeping him there, it's in his best interest. It doesn't matter if he can get away and avoid capture or not - the decision to flee is exactly why he should stay on. That's just his illness making him make bad decisions all over again. I don't know why mental illness often causes these kinds of thoughts but I've seen it happen. Schizophrenic patients deciding they do not need treatment anymore and stopping it. Several times. Even though after each relapse they have much worse symptoms and are generaly miserable and a danger to themselves. But time and time again they decide they know better then the doctors.

I'm no legal beagle either, but I'm pretty sure the hospital DOES gain something by keeping him there if they feel it's at minimum "medically necessary" all in the context of your good post. Namely, it would seem they gain liability protection if he were to leave and then like harm or kill himself or others.

That's not really a gain now is it. What I'm reffering to is that - many mentally ill people believe the medical doctors have an actual GAIN (money, power, some kind of sick twisted trip) by doing their job. They perceive it as keeping them sick/giving them a treatment that actually is causing their illness/other paranoid stuff.

It's easy to fall under paranoia, but there is no world wide doctor conspiracy because they really isn't anything to gain from keeping people under treatment. It makes no sense. It's a good thing to remember whenever your mind is clouded. Just because they're mentally ill does not mean you can't appeal to logic. they might FEEL they're ok, and the doctors are wrong. But if several doctors agree on something (thus eliminating any flaw in an individual medical decision), it means their FEELING of being ok is wrong.

I worked as a psych nurse for several years and it depends on the state where he is regarding how they handle people on holds. I never worked anywhere, even as a travel nurse, where the nurses/doctors tried to keep people unless they really needed to be there. Generally, if one is a danger to self or others, the staff have a legal and ethical responsibility to keep a patient safe even if that includes keeping you from leaving. Most likely your friend will not be able to "bust out"...most units are locked and very secure, worst case scenario would involve him trying to assault staff in order to leave and harming someone else who is just trying to help him. He would probably then just go from a locked psych unit to a jail when finally released. Sometimes people will focus on things like plans to get out or developing a relationship with another patient as a way to avoid confronting the real issues that brought them there. I hope he hangs in there and gets better.

Well, he is voluntary and would even be willing to go to another facility. The docs seems to think that no other place is good enough and are not willing to work with the other facility to set up a transfer.

He was forced in for a medical emergency in another state and when he wanted to leave to get back closer to his home for treatment they committed him and kept him at the general facility before transferring him to a nearby psych facility.

It actually may not be that hard for him just walk out and his plan is to get across the state border. Apparently emergency petitions are only for five days.

He wants to continue treatment but on outpatient basis near his family.

Strangely the docs won't even acknowledge this and refuse to work with him.

From personal experience, people who 'plan' escape attempts are not in the right frame of mind. You said before that he was INVOLUNTARILY, and they said it could be switched to voluntary in-treatment. Thing is, that's not always the case (Come to think of it, it sounds pretty inprobable to be completely honest). If he has proven to be incapable of taking care of himself (relapsing, as you say- though you never specify if it's a relapse in drugs or anything of that nature- to which if it is so it may be a court-ordered hospital stay).

Also, he can still be considered 5150 if he's a danger to himself and maybe not others. The hospital probably is keeping him for one reason or another, or that they saw something in his actions and/or behaviors that makes him unsafe to be trusted on his own in an outpatient facility. ESPECIALLY if he's a repeat offender as you said before, perhaps staying in in-treatment is the best possible situation for him unless he repeat the cycle over and over and over again.

If he is in outpatient, who is to stop him from 'relapsing' again? Who is to stop him from possibly killing himself or others while on his own? Hospitals don't keep people for **** and giggles. If he has proven to be unsuited to care for himself on MULTIPLE occassions- he may be in their care for a long time.

ALSO, 'being closer to family' might exacerbate existing mental issues and addictions- which is another reason why the hospital may be reluctant to release him. As cold as it sounds- sometimes being taken AWAY from family and friends can help in treatment tremendously- ESPECIALLY if the family and/or loved ones are enabling him and may reverse any and all progress made towards his recovery.

Point is, the hospital will release him when they deem it neccessary. AGAIN, Doctors and hospitals don't keep people because they are cold, heartless people. I think you need to look at how your friend acts and speaks, how their past history is, etc and make a decision there. Think about it, would YOU trust his word (a person who has been in mental facilities possibly more than once and continually 'relapses' annually) over that of a team of professionals who have gone to school for years and years to treat those in a mentally unstable state and have worked with him during his stay?

In all likelihood, if they find out he is getting ready to bust out and they think he needs to stay, they'll immediately put him on a 72-hour hold and get him on the involuntary track.

If he busts out before they figure it out, then either (1) they'll shrug their shoulders and wait for him to find himself back in the system, or (2) they'll notify law enforcement and go looking for him. My $$ is on number 2.